Телемедицина в акушерстве на территориях с низкой плотностью населения: правовые основы и практические результаты интеграции

Abstract

The purpose of the study is to characterize the legal framework for integrating telemedicine into the obstetric service in the light of the new Order of the Ministry of Health of the Russian Federation of 2010.2020 No. 1130n, to establish aspects of the use of telemedicine in obstetrics, and to show the practical results of its implementation. Material and methods. A scientific and analytical, retrospective study of all cases of the use of telemedicine technologies in the obstetric service of the Perinatal Center of Noyabrsk (Yamalo-Nenets Autonomous Okrug) in 2020 was carried out. Results. The main aspects of the use of telemedicine in obstetrics in areas with a low population density have been established, namely: selection of pregnant women requiring a high level of attention, routing of high-risk pregnant women in health care facilities of levels II and III, extreme conditions of pregnant women and newborns, pregnancy complications and negative medical and genetic prognosis of offspring, high-tech remote medical care for pregnant women, women in labor and newborns in federal healthcare facilities of III B level. The capabilities of patient-centered telemedicine technologies in the context of the COVID-19 pandemic have been determined. The clinical experience of the Noyabrsk Perinatal Center has proved that telemedicine counseling for pregnant women located in areas remote from the PC, prescribed by Order No. 1130n, significantly improves the quality of the regional obstetric care system. Conclusion. The Order of the Ministry of Health of the Russian Federation No. 1130 n ensures the effective integration of telemedicine technologies into the obstetric service, laying the foundation for the formation of a regional regulatory framework for obstetric telemedicine. Thanks to the new Order, the planned development of telemedicine obstetric networks and the organization of remote consulting centers in level III A health facilities have become mandatory. The Order gave impetus to the formation of electronic databases of high-risk pregnant women in each region. It provides for remote provision of both routine and emergency obstetric care. All this allows the obstetric service of the regions with the use of telemedicine to provide high-quality medical care to pregnant women, women in labor and parturient women, even in extreme conditions of epidemics and emergencies.